Delayed Sleep Phase Syndrome and Actigraphy

Delayed Sleep Phase Syndrome (DSPS) is a common type of the circadian rhythm disturbances. This sleep disorder is characterized by a delay in the sleep-wake cycle, where the patient experiences a chronic difficulty to fall asleep and awaken at socially accepted times.

Diagnosis

DSPS is often misdiagnosed as psychophysiological insomnia, depression, psychiatric disorders, or some other sleep disorder.

To diagnose DSPS one of the following must be done; a clinical interview, Actigraphy or a sleep log is kept by the patient. The Actigraphy is a procedure that uses a small instrument called an actigraph worn on the wrist or ankle. The actigraph is worn on the non-dominant limb for at least one week to record the person’s motor activity. The recorded data is later analyzed by computer to assess the sleep-wake cycle. Lately, actigraphy has been replacing the use of full polysomnography in the diagnosis of sleep disorders. Actigraphy is known to be used in academic settings and to determine certain factors in clinical trials.

Treatment

Treating DSPS patients basically revolves around adjusting their circadian rhythm and sleep pattern to allow them to live normal lives and fulfill the demands of day to day life - to fall asleep normally, wake up when necessary, feel rested and motivated. Treatment includes bright light therapy, chronotherapy or medication. Chronotherapy is a technique used during which the patient goes to bed 3 hours earlier each night and then sticks to strict bedtime. Patients are also advised to stick to regular daily routines and avoid stimulants including caffeine. Medications prescribed may include Vitamin B12, melatonin and/or sleeping aids. In more severe cases, bright light therapy may be used. The patient is exposed to bright light in the early morning.

Treatment

Treating DSPS patients basically revolves around adjusting their circadian rhythm and sleep pattern to allow them to live normal lives and fulfill the demands of day to day life - to fall asleep normally, wake up when necessary, feel rested and motivated. Treatment includes bright light therapy, chronotherapy or medication. Chronotherapy is a technique used during which the patient goes to bed 3 hours earlier each night and then sticks to strict bedtime. Patients are also advised to stick to regular daily routines and avoid stimulants including caffeine. Medications prescribed may include Vitamin B12, melatonin and/or sleeping aids. In more severe cases, bright light therapy may be used. The patient is exposed to bright light in the early morning.

Chronotherapy is a behavioral technique in which bedtime is systematically adjusted. Bright-light therapy is designed to reset a person’s circadian rhythm to the desired pattern. When combined, these therapies might produce significant results in people with DSPS. Patients can also be treated with one medicine that puts them to sleep earlier in the evening and another medicine that helps wake them up in the morning, but this form of treatment is usually used only in extreme cases.

Melatonin can be taken in the evening to advance sleep and circadian phases. But the science on melatonin is unsure and even sleep doctors don't know the right dose or when it should be taken.

Related: Familial Advanced Sleep-Phase Syndrome

Sleep Disorders

Dyssomnias

Parsomnias